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Thread: Shoulder instability

  1. #1
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    Shoulder instability

    For the past couple of months, my shoulder has been feeling "loose" or instable. I have some moderate pain and mostly the very odd feeling that it just is about to fall out of its socket. It usually feels okay while swimming but very bad afterwards. I've taken the past week off from swimming in the hopes that things would feel better, but no dice. I do have a call in to my doctor, but I've done some Googling around and it seems like it might be multi-directional instability of the shoulder. Does anyone have any experience with this? I am physically unable to participate in most other cardio (running, step aerobics, anything with any level of impact) so the idea of not being able to swim is very depressing.

  2. #2
    Very Active Member mcnair's Avatar
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    Re: Shoulder instability

    Definitely see the doctor, but it sounds like if it isn't hurting during swimming, only after, that it might be an imbalance of some kind. My shoulders were great for freestyle, but since the majority of my cardio was running for so long I didn't have a lot of stability in the muscles around the ones I used primarily for freestyle... so any little exertion outside my normal range of motion was "dangerous." Swimming the other strokes has helped and doing some stability exercises has helped too. Good luck.

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    Very Active Member jim thornton's Avatar
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    Re: Shoulder instability

    A good PT who has worked with swimmers should be able to help you with some rehab exercises to tighten up the muscles surrounding the tendon capsule that keeps your shoulder from popping out. Do not do stretching exercises as this will only make things worse. Some strokes are also harder than others on the shoulder capsule. Backstroke is hard.on the joint for lots of people. Don't worry. You won't have to quit but you will benefit from PT with chords and remarkably lower weights to tighten up the rotator cuffs and scapular stabilizers. Females fo tend to have looser connective tissue than men.or perhaps to say it different. We're less flexible. You need more strength. We.need.more flexibility. Sorry if typos...typing on phone. Goog.luck!

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    Re: Shoulder instability

    I have this problem in my left shoulder. I have dislocated it before and i even dislocated it once while racing when I started back in swimming 10 years ago.

    There is a set of exercises you can do with shock cords that strengthen your rotator cuff. I have had good success using these exercises when I have problems with my shoulder. I will see if I can find the sheet that shows them and post it. If you see a doctor or physical therapist, they will give you something similar.

    A couple of years ago I broke both shoulders in a skiing accident and the exercises they gave me after I healed were basically the same. I think you will find that with strengthening, it should not interfere with you swimming.

  5. #5
    Very Active Member swimshark's Avatar
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    Re: Shoulder instability

    Jim has some excellent points. It sounds like the shoulder needs to be strengthened to help it become stable. A bit of KT tape would probably help as well. A good PT can apply it well.

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    Very Active Member mermaid's Avatar
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    Re: Shoulder instability

    See your doctor, follow your doctors' orders. In the event they Rx PT and your insurance plan rejects it (it happens), here is a great video with exercises specific to swimming and shoulder stability. USMS' Dr. Jim Miller put this together with a couple of others.

    I hope this helps.
    Come live with me in the sea said she,
    Down on the ocean floor
    And I'll show you many's a wonderous thing
    That you've never seen before

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    Very Active Member __steve__'s Avatar
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    Re: Shoulder instability

    My left shoulder first dislocated anteriorally, fully, 20 years ago mountain biking in Moab. A Md passing by on a bike eased my suffering and popped it back in socket. The following decade it dislocated about ten more times where I learned to pop it back in myself.since I have started lifting weights, and more recently swimming, it has not happened in ten years. It does however feel loose at times, but usually following long distances with bad form or overuse. I have to live with this limitation but stability strength training DONE CORRECTLY and proper form seem to keep my arm held tight against its socket.

    Continue to avoid whatever is making it loose but just be assured there is hope doing what you enjoy without making it worse or even helping it . Many of the PT movements are excellent, but listen to how your shoulder responds specifically

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    Re: Shoulder instability

    Thank you all for the advice! I have an appointment with my PCP on Thursday now, but I'm sure she'll refer me either to PT or a specialist for anything helpful. I will definitely look into the strengthening exercises mentioned here. Is KT tape something that I could apply myself (after being shown how to do it)?

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    Re: Shoulder instability

    Here is a link with the excercise with bands:
    http://ptclinic.com/medlibrary/pdf/208.pdf

  10. #10
    Active Member swimslick's Avatar
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    Re: Shoulder instability

    Agree with others, sounds like some PT is in order. If you shoulder is just loose and you haven't actually dislocated it before, then you have a good chance with PT. An MRI might help to determine if it truly is multi-directional and the extent of the looseness, ie, if you have fraying or small to large tears in the labrum. Several years ago I fell and dislocated my shoulder, but unfortunately the damage was severe enough that multiple rounds of PT could not help. My shoulder kept popping out doing random daily things like putting on a shirt or reaching out to close my car door. Finally I got sick of constantly dealing with the painful aftermath so I went through with the surgery 5 months ago. But PT first, for sure!

  11. #11

    Re: Shoulder instability

    Evaluation by a physical therapist and diagnostic imaging (MRI) sound indicated in this scenario. For instability, improving the stability of the scapular stabilizing muscles (lower and middle trapezius) is likely more important than the rotator cuff muscle. Also, band exercises as indicated in one response treat the rotator cuff muscles are primary movers, which is not their main role! This is a common rehabilitative mistake, don't fall into the trap! Instead exercises of requiring the rotator cuff muscles to stabilize the humerus into the glenohumeral joint are needed to complement the exercises targeting the shoulder as the primary move (ie band exercises).

    Here is a link to a piece I presented at the NorCal Coaches clinic:
    http://www.swimshop.com/assets/image...lderNorCal.pdf

    For more examples, check out www.swimmingscience.net or you can purchase the swimmer's shoulder system www.corswimmershoulder.com, however an in-person evaluation by a licensed also sounds indicated in your scenario.

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    Re: Shoulder instability

    because of my own ailment i have become very educated on this subject.
    SLAP tear in august '09, but kept pushing it till march '10. finally surgery on it june '10. rehab and started swimming on it oct '10.
    swam good in '11 but started having issues around dec '11. started taking ibuprofin like candy. think a lot and then double it. plus aleave on top. ice measured in 10lb per day. did everything i knew to get through italy. then i had to back off the pain meds for fear of my liver. 3 mri's, over a dozen xrays. with 2 orthopeds at 2 different clincs.
    finally the 2nd week of jan '13 i started my own search for answers and found there is a difference between "shoulder instability" and "shoulder dysfunction". stability is usually because of a lack of strength in key shoulder muscles. dysfunction is usually because those muscles not working in a proper way. i have serious scapula dysfunction that caused atrophy of my trapezius and other scapula muscles. this atrophy then allows my humerous head to ride up into the glanus bone and force it into the clavicle at the ac joint and i get bone on bone grinding. this screws up my freestyle stroke and causes my fly to be 1 arm weaker than the other.
    i have done lots and lots of rehab, but am nowhere close to 100% or even 75%. i cant swim much (ie 400m total for last week). with no training i cannot race. our zone meet is 2 weeks away at one of the best pools in the usa and i will be a timer. nats is not even a consideration and so there is no way i can defend my national title.
    so, yes, i can understand your depression.
    seek out a pt (or many many youtube videos like i did) that can understand you are a swimmer and how we use our bodies.
    dont be affraid to try odd ideas or excercises.
    i wish you a speedy and complete recovery.

    steve

  13. #13
    Active Member swimslick's Avatar
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    Re: Shoulder instability

    stability is usually because of a lack of strength in key shoulder muscles.
    actually, shoulder instability is caused by having loose or stretched out tendons and/or joint capsule so that the shoulder does not function properly in the socket. it basically wobbles around and grinds up on stuff that it shouldn't. the looseness/instability is usually caused by traumatic injury (ex: dislocation due to forceful impact), or due to overuse which is more common among swimmers and other athletes. (instability due to overuse can eventually lead to partial or total dislocations down the road.) it can also be caused by age and normal wear and tear - i think i read that shoulder instability is quite high among the senior aged population for instance.

    anyway, having strong shoulder muscles definitely helps negate and can sometimes eliminate the effects/symptoms of the instability, which is why it is often hard to diagnose and why PT can be very successful. but the root problem is always there, unless surgically fixed.

    steve, do you know the cause of your scapula dysfunction? was it a result of your surgery/recovery? i've never heard about dysfunction before and would like to avoid it if possible lol.
    Last edited by swimslick; March 20th, 2013 at 07:47 PM.

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    Re: Shoulder instability

    everything points to my dysfunction being a direct result of my surgery and recovery. in that my muscles were not working correctly and i am suffeciently strong enough to overcome that with other muscle groups to still allow me to swim. well, to a certain point that the atrophy became so bad that i could not over compensate. none of my post-surgery rehab included anything that i can think that would have prevented this. most unfortunate for me.

    from about 2:11 on in this video -> gives some good examples of what i have.
    my brother is a PT (but does not live in the same city i do) and i sent him videos of my back in motion. he also works as a personal trainer in a gym. in the few days after he saw this video he tested his clients and most of the muscular men had issue where the women did not. no i am in the extreme area. where my neck is not the same on my bad side as it is on the good side. in a tshirt you can visably see the atrophy.

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    Re: Shoulder instability

    I really appreciate all this info! I have an appointment tomorrow morning and I'm armed with lots of info.

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    Re: Shoulder instability

    Quote Originally Posted by SuperChloe View Post
    I really appreciate all this info! I have an appointment tomorrow morning and I'm armed with lots of info.
    let us know how it goes. i am in the process of trying to see yet a 3rd ortho.

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    Re: Shoulder instability

    Okay, my PCP thinks it's bursitis of the AC joint. I will start PT in about 2 weeks (I'm going to be away for break). I have an NSAID regimen and I'm supposed to ice, ice, ice. She said I can still swim but to cut wayyyy back until I'm healed, mostly doing kicking. I can live with that if all it is is bursitis! I am slightly skeptical since I have been having the looseness feeling, but I'm going to give this a shot and see how it goes.

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    Paint test area ahead Michael Heather's Avatar
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    Re: Shoulder instability

    Interesting diagnosis. I am not a doctor, so I can only tell you what I have experienced and/or have been told.

    Stretching: done correctly, it will not affect your condition. The stretch is for the muscles, not the joints.

    Loose feeling with attendant pain could also be a stroke-related issue. Most doctors and PTs are not familiar with our unique use of muscle groups, but a good PT can actually correct your stroke mechanics through exercises and positioning. I had one session with a PT that removed all of my pain, simply by his observations of my stroke (lying on a table) and suggestions for change. I don't claim that this will be the case for you, but it is possible.

    Swimming uses a lot of muscles in the shoulder and chest, but often we forget the many little muscle groups in the back that hold the shoulder together. You will likely do a lot of exercises to develop those.

    Best of luck and don't rush your recovery. There is plenty of time to swim.
    The opinions expressed in the above post are mine, not those of U.S. Masters Swimming. But maybe they should be.

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    Re: Shoulder instability

    Quote Originally Posted by SuperChloe View Post
    Okay, my PCP thinks it's bursitis of the AC joint. I will start PT in about 2 weeks (I'm going to be away for break). I have an NSAID regimen and I'm supposed to ice, ice, ice. She said I can still swim but to cut wayyyy back until I'm healed, mostly doing kicking. I can live with that if all it is is bursitis! I am slightly skeptical since I have been having the looseness feeling, but I'm going to give this a shot and see how it goes.
    while i am no doctor, i find it very odd that is the diagnoses.
    http://www.webmd.com/pain-management/arthritis-bursitis
    if you can go through pounds and pounds of ice (or bags of frozen peas/corn) like have and bottles of ibuprofin you will quickly learn that is either not the correct diagnoses or not the right treatment. for me even weeks off did nothing.
    have someone video your back in motion (ie military press motion) and compare it to the video link i posted above.

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    Re: Shoulder instability

    A great article on the issue of Shoulder instability.
    Shoulder Injury Prevention
    Presented by USA Swimming and the Network Task Force on Injury Prevention. (April 2002)
    Introduction by Scott Rodeo, MD // Chair of the USA Swimming Sports Medicine/Science Committee and Team Physician for the NFLís NY Giants


    http://www.usaswimming.org/ViewMiscA...702&ItemId=700

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